Winston D J, Dudnick D V, Chapin M, Ho W G, Gale R P, Martin W J
Arch Intern Med. 1983 Jan;143(1):32-6.
From January 1977 to June 1980, coagulase-negative staphylococci caused bacteremia in 22 (17%) of 130 patients receiving immunosuppressive therapy and were the most common cause of all bacteremias. Sixteen (73%) of the 22 patients had granulocytopenia, and eight were isolated in a laminar air-flow room. A Broviac or Hickman central intravenous (IV) catheter was present in 20 (91%) of 22 patients, and soft-tissue inflammation at the catheter exit site was a significant risk factor for bacteremia. Except for debilitating fevers and local mucocutaneous infections, there were no distinguishing clinical features in patients with bacteremia. Most infections responded to cefazolin sodium or vancomycin hydrochloride therapy; catheter removal was necessary in only seven patients. These data show that coagulase-negative staphylococci can be important pathogens in patients receiving immunosuppressive therapy, even when the patients are isolated in a laminar air-flow room, if normal mucocutaneous, host-defence barriers are interrupted by IV catheter-insertion or chemotherapy.
1977年1月至1980年6月，在130例接受免疫抑制治疗的患者中，凝固酶阴性葡萄球菌导致22例（17%）发生菌血症，是所有菌血症的最常见病因。22例患者中有16例（73%）存在粒细胞减少症，8例在层流空气病房中隔离。22例患者中有20例（91%）置有Broviac或Hickman中心静脉导管，导管出口部位的软组织炎症是菌血症的重要危险因素。除了虚弱性发热和局部黏膜皮肤感染外，菌血症患者没有明显的临床特征。大多数感染对头孢唑林钠或盐酸万古霉素治疗有效；仅7例患者需要拔除导管。这些数据表明，即使患者在层流空气病房中隔离，但如果正常的黏膜皮肤宿主防御屏障因静脉导管插入或化疗而中断，凝固酶阴性葡萄球菌可能成为接受免疫抑制治疗患者的重要病原体。
